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What are effective ways to resolve conflicts with patients who have disabilities?

As a nurse, you may encounter situations where you have to deal with patients who have disabilities that affect their communication, behavior, or decision-making. These patients may have different needs, preferences, or expectations than other patients, and may express their dissatisfaction, frustration, or anger in ways that challenge your patience, professionalism, or ethics. How can you resolve conflicts with patients who have disabilities without compromising your quality of care, your relationship with them, or your own well-being? Here are some effective ways to approach these situations.

1 Understand the disability

The first step to resolving conflicts with patients who have disabilities is to understand how their disability affects their perception, expression, and response to conflict. For example, a patient who has autism may have difficulty understanding social cues, emotions, or sarcasm, and may react strongly to changes, noises, or touch. A patient who has dementia may have memory loss, confusion, or paranoia, and may not recognize you, their surroundings, or their condition. A patient who has a hearing impairment may have trouble hearing your instructions, questions, or explanations, and may feel ignored, misunderstood, or disrespected. By learning about the disability and its impact on the patient, you can tailor your communication, intervention, and resolution strategies to suit their needs and abilities.

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Marguerite Elisofon

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In my experience with my autistic daughter, modeling calm during a melt down is the best approach( though sometimes difficult). Offering choices a la MBA can work if offered respectfully. Ask what do you think would work better? Remind the patient of the consequences of their last meltdown (in my daughter's case, it's verbal aggression and 4 letter words). How did that work out? What would you prefer? Remind the patient that if you scream and are verbally aggressive, you will lose your audience and NOT get what you want. Explain that it's perfectly normal for people to be angry or disagree, but then role play and offer a more effective way to communicate negative emotions, so that people will be sympathetic. Sometimes, humor works:)

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Ricardo Rodríguez Franco

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My father used to say:"There is no worse blind than the one who does not want to see, nor worse deaf than the one who does not want to hear." He was right. Not reasonable people don't want to see nor hear. So, if you chose such client, you have no one to blame but you. If you didn't, send him to the one who did.

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2 Communicate respectfully and clearly

The second step to resolving conflicts with patients who have disabilities is to communicate respectfully and clearly with them. This means using appropriate language, tone, and body language, and avoiding assumptions, judgments, or stereotypes. For example, you should use person-first language (e.g., a person who has diabetes, not a diabetic), avoid patronizing or infantilizing terms (e.g., honey, sweetie, good boy), and address the patient directly, not through their caregiver or companion. You should also speak slowly, clearly, and calmly, and use simple and concrete words, sentences, and examples. You should check for understanding, repeat or rephrase if necessary, and use visual aids, gestures, or written materials if helpful. You should also listen actively, empathetically, and attentively to the patient's concerns, feelings, and perspectives, and acknowledge them without dismissing or invalidating them.

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Mary Skalski

Encouraging strength and growth in the face of life’s challenges.
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When my clients who were dual diagnosed with both mental retardation and severe and persistent mental illnesses became angry,upset or distraught one staff would talk to them alone to discern what the problem was. Calmly talking one on one quickly before they escalated helped keep the environment safe for all.Using simple words and a relaxed manner helped. Using their strengths to devise solutions helped them connect and own solutions.

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3 Identify the source and the goal of the conflict

The third step to resolving conflicts with patients who have disabilities is to identify the source and the goal of the conflict. This means finding out what is causing the conflict, what the patient wants or needs, and what you can do to help them. For example, the source of the conflict may be a misunderstanding, a disagreement, a violation, or a challenge. The patient may want or need more information, more autonomy, more respect, more comfort, or more support. You may be able to help them by providing clarification, offering options, apologizing, adjusting, or referring. By identifying the source and the goal of the conflict, you can focus on finding a solution that meets the patient's needs and expectations, and aligns with your professional standards and responsibilities.

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4 Collaborate and compromise

The fourth step to resolving conflicts with patients who have disabilities is to collaborate and compromise with them. This means working together to find a mutually acceptable and beneficial outcome, and being flexible and willing to make concessions if possible. For example, you can ask the patient for their input, suggestions, or preferences, and involve them in the decision-making process. You can also explain the benefits and risks of different options, and the rationale and evidence behind your recommendations. You can also negotiate and agree on a plan of action, and review and revise it as needed. By collaborating and compromising with the patient, you can build trust, rapport, and satisfaction, and reduce resistance, hostility, and resentment.

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5 Follow up and follow through

The fifth step to resolving conflicts with patients who have disabilities is to follow up and follow through with them. This means checking on their progress, feedback, or concerns, and delivering on your promises, commitments, or expectations. For example, you can call, visit, or email the patient to see how they are doing, how they are coping, or how they are feeling. You can also provide them with additional information, resources, or referrals if needed. You can also monitor and document their outcomes, compliance, or satisfaction, and report and escalate any issues or problems if necessary. By following up and following through with the patient, you can demonstrate your care, respect, and professionalism, and ensure the quality and continuity of your service.

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6 Learn and improve

The sixth step to resolving conflicts with patients who have disabilities is to learn and improve from them. This means reflecting on your experience, performance, and feedback, and identifying your strengths, weaknesses, and areas for improvement. For example, you can ask yourself what you did well, what you could have done better, and what you learned from the conflict. You can also seek feedback from the patient, their family, your colleagues, or your supervisor, and listen to their compliments, criticisms, or suggestions. You can also seek opportunities for education, training, or mentoring to enhance your knowledge, skills, or attitudes. By learning and improving from the conflict, you can increase your competence, confidence, and credibility as a nurse.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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What are effective ways to resolve conflicts with patients who have disabilities?

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1 Understand the disability

2 Communicate respectfully and clearly

3 Identify the source and the goal of the conflict

4 Collaborate and compromise

5 Follow up and follow through

6 Learn and improve

7 Here’s what else to consider

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